Remember playing -peek-a-boo with a baby?
Remember how the baby is all excited that you managed to disappear behind your hands, then magically reappear?
Babies are fascinated by your magical skills.
They giggle. They laugh. They love you.
I was reminded of this last week when a prescriber called me to question a dose she prescribed for her pediatric patient. (Let's ignore the fact that she waited until 6 hours after sending the e-script to call, by which time the patient's mom already picked up and administered a dose.)
CP: Thank you for calling CP's pharmacy where you currently have the privilege of speaking to the infamous, self-deprecating CP. How may I help you?
Following Through on Writing: I was calling to double-check the dosing on a prescription I sent over for Little Tyke earlier.
CP: I recall. Is that the one for Amoxicillin 250mg/5ml?
FTW: It is. I usually calculate my own doses but I let the computer calculate it for me and I didn't double-check. It doesn't round and I entered the patient's weight and just went with what it said. It seems a little high now that I think about it.
CP: I remember this one. Mom already came and got it and we talked to her about it.
CP: Yes, but do not worry. We calculated the dose several times. We have students on rotation and one of the doses I make them memorise is the max of Amoxicillin. This worked out well because I had them do the calculation.
FTW: But I didn't put the weight on the prescription.
CP: I know. We don't need it. In any equation, as long as you have 2 of the 3 numbers, you can solve for the 3rd. We knew the max dose per day and we knew the dose you prescribed. Using these numbers we could find the patient's weight. We put a note on the patient's prescription at pickup. We asked mom to verify that LT weighed at least 70lbs and was being treated for strep.
FTW: How'd you do that? That's amazing. LT was diagnosed with strep and weighs 73 lbs. Really? You did all that?
CP: It's what we do here. The dose appeared high so we double-checked it. It was a great exercise for my students and for me. As Bon Jovi sang, "It's my license".
FTW: "It's my life"?
CP: You get me! Anyway, I know not all 12 year olds weigh the same. I make my students memorise other max doses as well so they can quickly calculate doses on the most commonly prescribed or recommended products for parents and their children. (Benadryl, Ibuprofen, and Acetaminophen especially.) Besides, if the dose seems off or if mom didn't answer the questions at pickup correctly, we would certainly have called you before it left the pharmacy.
FTW: I'm so impressed! I never knew you guys did that. Thank you so much for looking out for us and our patients.
CP: We all have the same goals in mind. You and I share the same patients and we're both busy. We are the last line of defence from a bad day. I know medications. I know doses. I know how to quickly calculate doses in my head. It's what I do.